Wisconsin City is Sending Mental Health Professionals Instead of Police to Respond to Some 911 Calls
On September 1, 2021, Madison, Wisconsin, launched a new program designed to take a more therapeutic approach in addressing community mental health crisis calls. The new service is focused on serving areas where city officials believe the majority of these types of calls originate. According to a recent report, after just one month, the program was already showing signs of early success. Here is more on how this Wisconsin city is sending mental health professionals instead of police to respond to some 911 calls.

Community Alternative Response Emergency Services (CARES)

Madison’s new program, Community Alternative Response Emergency Services (CARES), provides a team-based approach in responding to mental health crisis calls. The CARES team is comprised of Madison Fire Department paramedics and mental health crisis workers from Journey Mental Health. CARES is being overseen by the Madison fire department and provides services to the city’s downtown and university areas from 11 a.m. to 7 p.m. 

One of the program’s main goals is to remove barriers that are preventing people who are experiencing behavioral health issues from accessing supportive services. To help with engagement, CARES team members respond to behavioral health calls wearing plain clothes instead of uniforms. They also arrive in a mini-van bearing the CARES logo rather than in an emergency response vehicle with flashing lights and sirens.

In a recent interview, Journey Mental Health Crisis worker Shequila Galvez commented regarding the team's approach. Galvez stated that "[h]aving a whole team that focuses on the whole person physically, mentally, and emotionally delivers greater care to whoever is in need.” Galvez also remarked that the team’s clothing and response vehicle make them more approachable. CARES paramedic Mark Norton reported that he has received a positive response from those he has served and feels that members of the team… "[b]ring different skill sets to the table and sort of complement each other." In addition, both Norton and Galvez related that offering an alternative to those who dial 911 provides an important community benefit.

During its first month, the CARES team reportedly responded to 37 mental health-related emergency calls. The team anticipates continuing to respond to an average of three calls per day. The program is also designed so that team members can follow up with the individuals they serve.

According to a recent news report, the CARES program is part of the city’s overall “response to a larger volume of mental health incidents and come[s] amid increased scrutiny of police use of force nationwide.” CARES was spearheaded by District 11 Alder and Common Council Vice-President Arvina Martin. Martin related that she had an experience when she was reluctant to contact the police to assist a friend who was having a mental health crisis that involved alcohol. She stated that, at the time, she was uncertain if calling the police would make the situation better or worse.

CARES is expected to cost the city approximately a half-million dollars annually and is being offered in addition to mental health unit services provided by the Madison Police Department. The CARES program was modeled from others located in Denver, Colorado, and Portland, Oregon.

In Wisconsin, police departments, such as those in Eau Claire, Janesville, and Superior, have also been making efforts to work with mental health professionals to assist those in crisis. Jim Palmer, Executive Director of the Wisconsin Professional Police Association, recently commented that the number of Wisconsin police departments with mental health units is unknown. He also related that it is unclear if other state police departments will follow a mental health diversion model. 

According to a recent report, last year, the association proposed A Blueprint for Change measure that was created after George Floyd’s Minneapolis murder. The proposal asks that the state support pilot programs that provide crisis response innovations and advancements. Additionally, in October, the Wisconsin legislature held a public hearing on Assembly Bill 333. The pending bill calls for the expansion of a state grant program to establish and enhance law enforcement and behavioral health service emergency response efforts.

If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental disabilities. To schedule a consultation, contact us or call (509) 991-7058.
Suicide and its Impact on the Criminal Justice System
By Elizabeth Kelley and Francesca M. Flood
Whether you are a defendant, family member, criminal defense attorney, prosecutor, judge, law enforcement officer, academic, or mental health professional, this book provides much-needed information about a pervasive phenomenon––suicide in the criminal justice system.

For far too long, speaking about suicide was a taboo subject. Today, it is a topic we cannot avoid, and we are finally coming to terms with its pervasiveness across all races, ethnicities, religions, and professions. Yet despite this growing awareness, we have yet to acknowledge and address the arc of suicide in the criminal justice system.

In this seminal work, the authors enlist the insights of academic specialists, professionals within the criminal justice system, and individuals who have served time to bring voice to the subject of suicide within the criminal justice system. This unique book provides insights that have yet to be broadly examined. Whether you are a defendant, family member, criminal defense attorney, prosecutor, judge, law enforcement officer, academic, or mental health professional, this book provides much-needed information about a pervasive phenomenon––suicide in the criminal justice system.
Elizabeth Kelley
Criminal Defense Attorney
Elizabeth Kelley is a criminal defense lawyer with a nationwide practice specializing in representing people with mental disabilities. She is the co-chair of The Arc's National Center for Criminal Justice and Disability, serves on the American Bar Association’s Commission on Disability Rights, Criminal Justice Section Council, and Editorial Board of the Criminal Justice Magazine Learn more.
Additional Resources
Phillip Adams Had Severe C.T.E. at the Time of Shootings
A neuropathologist found an “unusually severe” form of the brain disease in the 32-year-old former N.F.L. player who killed six people in April before shooting himself.

The posthumous brain examination of Phillip Adams, a 32-year-old retired journeyman N.F.L. player who shot and killed six people before dying by suicide in April, revealed that he had an “unusually severe” form of C.T.E., a degenerative brain disease found in athletes and others with a history of repeated hits to the head.

Dr. Ann McKee, director of the C.T.E. Center at Boston University, said an examination of Adams’s brain showed significantly dense lesions in both frontal lobes, an abnormally severe diagnosis for a person in his 30s that most nearly resembled that of Aaron Hernandez, a former New England Patriots tight end who was 27 years old when he died by suicide after being convicted of a 2013 murder.
In 'Tastes Like War,' a daughter reckons with her mother's schizophrenia
Grace M. Cho emigrated to the U.S. as a baby, with her Korean mother and her father, a white American who served in the Merchant Marines. They settled in a small, rural town in Washington state, where they were among the only immigrants in the community.

"Children used to tease me and bully me for being Asian," Cho says. "I also started to notice that these kinds of things also happened to my mother, sometimes in ways that were even more dramatic than what I had experienced."

In those early years, Cho's mother, Koonja, turned to the kitchen as a way to cope. She cooked elaborate meals for their white neighbors and for Cho's teachers, and she began foraging the nearby forests for wild mushrooms and blackberries.
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Ian Fishback revealed abuse of detainees during the Iraq war, but struggled after leaving the service. He died awaiting a bed at the V.A.
Ian Fishback saw the world as cleaved between the just and unjust, the exemplary and the erring. A scholar-athlete from a small town in northern Michigan, he chose the military as his path toward a principled life, and when the Army failed its own credo during the war in Iraq, he persisted in making the truth known.

Major Fishback, who had retired from the Army, died last week, in circumstances still unclear, alone and broke in a group home, convinced he was being persecuted by the very forces he had once embraced. He was 42.
How Do Autistic Individuals Interact with the Criminal Justice System?
Across the United States, reports of autistic youth experiencing dangerous, life-altering and even fatal interactions with the criminal justice system are becoming more common. Research suggests that autistic individuals interact with police at high rates and individuals with disabilities disproportionately experience police violence. 

Researchers from the A.J. Drexel Autism Institute at Drexel University recently published research that identified the experiences of autistic individuals and their caregivers across their interactions with the criminal justice system through analysis of a statewide survey in Pennsylvania.

The study analyzed free-text responses and multiple-choice questions about types of justice system interactions from the 2018 Pennsylvania Autism Needs Assessment (2018 PANA), a large survey of autistic individuals and their families that included questions about demographic and clinical information, as well as service needs and experiences.
On Rikers Island, a Doctor Who Tends to the Oldest and Sickest
Insights from Dr. Rachael Bedard, a jail-based geriatrician.
Five years ago, Dr. Rachael Bedard was finishing a fellowship in geriatrics and palliative care at a hospital in Manhattan when she began to wonder if there were elderly detainees in need of care just across the East River, at Rikers Island.

Dr. Bedard wrote to the chief of medicine for the city’s jail system and asked if Rikers had “an aging problem.” He offered her a job.

“It was a really amazing, door-opening opportunity to come and learn about a population that’s generally underrecognized,” Dr. Bedard said of joining the jails’ public health care provider, which had replaced a for-profit contractor the year before.
A close look at mental illness in Los Angeles County jails
Offenders in jail may commit crimes because of their mental health issues. Is jail truly the best place for them?
There is a growing percentage of people with mental illness in Los Angeles County jails.

Offenders in jail may commit crimes because of their mental health issues.

Dan Kennedy, a professor of criminal justice in Detroit and expert witness for jail suicides, says about 65% of people incarcerated have mental health issues.
Books
Representing People with Mental Disabilities: A Criminal Defense Lawyer's Best Practice Manual

Published by the American Bar Association. Topics include:

  • Competency
  • Sanity
  • Malingering
  • Neuroscience
  • Jail and Prison Conditions
Representing People with Autism Spectrum Disorder: A Practical Guide for Criminal Defense Lawyers

Published by the American Bar Association. Topics include:

  • Co-Occurring Disorders
  • Testing
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  • Risk of Violence
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